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Severe pain

Hello. Firstly apologies if I am posting this in the wrong place - I am new to this forum. My name is Carolyn and I am posting on behalf of my husband Mike who underwent his second spinal laminectomy on 7 April, 15 months after the first.

His first surgery was carried out at a private hospital here in Turkey to solve a 50 year old back pain which had gone unsolved in the UK. At first all was good after initial setbacks involving pain from a haematoma. Once that was cleared he walked tall and without pain. Then last winter he began to get pains in his knees and hip and started what I called his Charlie Chaplin shuffle. As the orthopaedic surgeon had said he needed two new knees and a new hip once his back surgery had been completed we thought we knew where we were headed.

Our friend works in a second, more modern private hospital and suggested we see their surgeon possibly with a view to having prp injections. When we saw him and he arranged for xrays he said the pain was nothing to do with knees and hip and said Mike had "Flat Back Syndrome". The first surgeon hadn't put a curve into the rods in his lumbar spine so causing pressure on the nerves and the anterior of the vertebrae. He said he would remedy this in a two hour operation by removing, curving and refixing the rods and reintroducing the proper space between vertebrae. The simple two hour operation turned into five as when he opened the back he found the spine was unstable, the rods were very loose and when he came to take them most of the screws came away too. He replaced screws with longer, bigger and stronger ones, refitted the newly curved rods and sent him to ICU for 18 hours. Within a day or so he was walking quite well and two drains were taking away fluids. He was discharged on day 4 and I was advised to change the dressings on a daily basis. His wound was closed with 37 staples.

Fluid continued to leak copiously from an area near the base of the incision. The doctor said it was normal and good. I was changing dressings at least four times daily and lying him on towels to prevent seepage onto bedding and soft furnishings. Around this time his pain levels began to raise dramatically. We were back at the hospital on day 9 and the doctor said weeping was normal and good. Gave pain killing injections which worked although pain levels rose after injection wore off. On day 13 I called an ambulance as he could not move because of the pain. The doctor met us there and arranged for blood tests and an xray. Xray good. They kept him in overnight. On Day 16 I took him back in and surgeon said he would reopen the back and clean the area of discharge. He took a swap from the leaking fluid for culture and arranged more blood tests. He was kept in for 13 nights and had mri and blood tests. Still the discharge continued. After leaving hospital the pain continued. The hospital said he needed bed rest with minimal movement to allow healing.

33 days after surgery he was readmitted. Unable to walk normally or move for even short distances because of pain. The doctor said he would stay there until the discharge had cleared and the remaining 1/2 inch of open wound had closed. 7 days later he was discharged. The doctor was pleased at a check up 7 days after that.

Although he had been slowly building up distance walked following his last discharge from hospital - mainly by walking in and around the house/on the balcony, he has been unable to either stand still or sit down. We were told that this was normal as both put greater pressure on his back. One week ago today I took him back for a consultation has his pain levels have not reduced and we both feel his progress is minimal or even non existent. The doctor was called into surgery on his way to us but ordered more blood tests. When these came back they showed a CRP of 5.41 (normal range 0 - 0.5) and a sedimentation level of 73 (normal level 0 - 15). Indicators of inflammation and infection. When I managed to get copies of earlier results these indicated that the earliest test for CRP taken on 4 May showed at level of 2.10. It has continued to rise since then and even after treatment in hospital with IV antibiotics it was 3.67 at time of his last discharge. Further investigation showed that 17 days after his operation he had tested positive for Staphylococcus Epidermidis which no one had advised us of.

He has consistently maintained that his pain is to the right of his spine, towards his hip, and it is a burning pain. He describes it as feeling like a cushion. There is nothing visible on the surface of his skin and pressure over the area causes no pain, nor is it sensitive to the touch. I am wondering if it could be a seroma - fluid that has built up now it has nowhere to escape. He his into a 10 day course of Ceftinex. Which is apparently the one oral antibiotic effective in treating Staph. He is also taking a cocktail of painkillers and anti-inflammatories. Although he has previously taken several courses of antibtiotics it would seem that they are all broad spectrum and none to target Staphylococcus specifically although in fairness I do not know what he was taking iv when an inpatient.

Whether coincidence or not, he describes this area of pain/swelling/burning to be in exactly the same place at the haematoma 15 months earlier although ultrasound, MRI and xrays have identified nothing physically or surgically wrong.

I am wondering if anyone here has experienced anything similar? I have made a follow up appointment for him tomorrow and I am going to ask for more blood tests. If they results indicate some improvement infection wise I will ask for further courses with regular blood testing until his levels are completely normal. I am also very worried about the area of pain and wonder what we can do or suggest. Until this is cleared we can't be sure if the surgery itself has been successful.

Please accept my apologies for such a long winded first post but I have tried to give as much information as possible.


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